Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 27;18(7):e0288551.
doi: 10.1371/journal.pone.0288551. eCollection 2023.

Analytical performance of the digital morphology analyzer Sysmex DI-60 for body fluid cell differential counts

Sumi Yoon  1 , Hye Ryoun Kim  1
Affiliations

Analytical performance of the digital morphology analyzer Sysmex DI-60 for body fluid cell differential counts

Sumi Yoon et al. PLoS One. .

Abstract

Background: Sysmex DI-60 (Sysmex, Kobe, Japan) is a digital morphology (DM) analyzer widely used in clinical laboratories and supports body fluid (BF) applications. We evaluated analytical performance of DI-60 compared with XN-350 (Sysmex) and manual counting for BF cell differential counts.

Methods: A total of 213 BF samples were collected (47 cerebrospinal fluid [CSF], 80 pleural fluid, and 86 ascites samples). The analytical performance of DI-60 for BF cell differential counts was evaluated based on sensitivity, specificity, accuracy, and agreement. BF cell differential counts obtained by DI-60 were compared with those obtained by XN-350 and manual counting.

Results: The overall sensitivity was high for neutrophils, lymphocytes, and macrophages (range, 83.1-99.4%). The overall specificity and overall accuracy were high for all cell types (range, 95.3-99.7% and 94.3-99.3%, respectively). The agreement between DI-60 pre-classification and verification was strong (κ = 0.89). The absolute mean differences between DI-60 verification and XN-350 ranged from 0.26 to 11.05, and differences between DI-60 verification and manual counting ranged from 0.01 to 4.76.

Conclusions: This is the first study to evaluate the performance of DI-60 compared with XN-350 and manual counting for BF cell differential counts. DI-60 showed reliable performance with CSF, pleural fluid, and ascites samples. For BF cell differential counts, DI-60 may be a better option than XN-350 and could be used for screening purposes in understaffed laboratories. To improve the hematology workflow for BF cell differential counting, the DM analyzer needs to be optimized by taking into account the laboratory situation and unmet needs, and the clinical laboratory needs to establish criteria for verification and manual slide review.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Comparison between DI-60 and XN-350 (n = 213).
Solid line, Passing-Bablok regression; dashed line, 95% confidence interval line.
Fig 2
Fig 2. Comparison between DI-60 and manual counting (n = 213).
Solid line, Passing-Bablok regression; dashed line, 95% confidence interval line.
See this image and copyright information in PMC

References

    1. Boer K, Deufel T, Reinhoefer M. Evaluation of the XE-5000 for the automated analysis of blood cells in cerebrospinal fluid. Clin Biochem 2009;42:684–91. doi: 10.1016/j.clinbiochem.2009.01.025 - DOI - PubMed
    1. Zimmermann M, Ruprecht K, Kainzinger F, Heppner FL, Weimann A. Automated vs. manual cerebrospinal fluid cell counts: a work and cost analysis comparing the Sysmex XE-5000 and the Fuchs-Rosenthal manual counting chamber. Int J Lab Hematol 2011;33:629–37. doi: 10.1111/j.1751-553X.2011.01339.x - DOI - PubMed
    1. Labaere D, Boeckx N, Geerts I, Moens M, Van den Driessche M. Detection of malignant cells in serous body fluids by counting high-fluorescent cells on the Sysmex XN-2000 hematology analyzer. Int J Lab Hematol 2015;37:715–22. doi: 10.1111/ijlh.12393 - DOI - PubMed
    1. Clinical and Laboratory Standards Institute (CLSI). Body fluid analysis for cellular composition; approved guideline. CLSI Document H56-A. Wayne, PA: CLSI; 2006.
    1. Buoro S, Peruzzi B, Fanelli A, Seghezzi M, Manenti B, Lorubbio M, et al.. Two-site evaluation of the diagnostic performance of the Sysmex XN Body Fluid (BF) module for cell count and differential in cerebrospinal fluid. Int J Lab Hematol 2018;40:26–33. doi: 10.1111/ijlh.12723 - DOI - PubMed

Publication types